this man comes in from the hosp. to our ltc. he is end stage everything you can think of and in pretty bad shape. when the hosp. called in report, they told me he was a brittle diabetic...boy were they ever telling the truth! she tells me his bg's were in the 40s but some dextrose did the trick and now it's in th 90s. when he gets here, its in the bloody twenties!!! protocol glucagon and 1hr later, it dipping instead of climbing and this man is still responsive. he's DNR but the dang thing is not signed by family but the doc has written it 2wice in the admission orders for good measure. did I mention he also orders the man not be sent back to hosp???? call the family and yeah the doc discussed the dnr thing with them and they agreed, but that dang paper is not gonna sign itself and they can not come to the facility coz they are busy tonight. so is the man to be coded or not if need be??? and what the heck is the protocol for glucagon anyways?? it just says give so many mgs IM,,,doesn't say repeat times what if ineffective. Oh yeah,, we have a super, but she's trying to cover 3 nurse call ins for tonite and cover a floor. did I mention the admission orders WERE verified with the on call and he knows the family hasn't signed, and now he says what do you mean you don't have the documents?? another glucagon shot later and the bgs climb to 36 yeepie!! and oh yeah its end of shift and someone has to start a dextrose IV (not me,,not certified) and the oncoming nurse doesn't wanna hear report you are not leaving me with a dying man, she says, am going home. Oh yeah?? You and me both. what the heck do you think your job is???? And then we are told to call family and get a verbal order from them to put in the dnr form so that it can be official. is that even legal, isn't that forging someone's signature? what if the man dies and the family decides they did not authorize a dnr after all?? I know,, am rambling, but that's how my mind is working right now. how the heck do u accept an admit knowing full well he needs to still be in the hosp,,,then all the big kahunas go home for their long weekend and am left to deal with the crap!! Then to top it all off, the noc cna assigned 2 that station comes in 1hr late and wants to know why this man is laying on hosp issue linen. ain't nobody touched this man all night, she says. the man is not wet (probably can't piss and needs a foley) or soiled, she just doesnt want to have 2 do anything 2nite. So while she's still b>>>>ing I walk to the time clock and clock out then ask her do u want us 2 save the man or worry about what color linen he's laying on? I am calling in on monday and putting in ma notice on teusday and hopefully the state will not come after me. What do people do if they lose their license??? happy memorial day y'all.
